Monday, July 15, 2019

Vector-Borne and Zoonotic Diseases

Human Seroprevalence of Tick-Borne Anaplasma phagocytophilum, Borrelia burgdorferi, and Rickettsia Species in Northern California
Published Online:

There is a paucity of data on human exposure to tick-borne pathogens in the western United States. This study reports prevalence of antibodies against three clinically important tick-borne pathogens (Borrelia burgdorferiAnaplasma phagocytophilum, and Rickettsia spp.) among 249 people in five counties in northern California. Individuals from Humboldt County were recruited and answered a questionnaire to assess risk of exposure to tick-borne pathogens. Samples from other counties were obtained from a blood bank and were anonymized. Seventeen (6.8%) samples were seropositive for antibodies against at least one pathogen: five for A. phagocytophilum, eight for B. burgdorferi, and four for Rickettsia spp. Women and people aged 26–35 had higher seroprevalence compared to other demographic groups. Santa Cruz County had no seropositive individuals, northern Central Valley counties had three seropositive individuals (all against A. phagocytophilum), and Humboldt County had 14 (all three pathogens), a significant, four-fold elevated risk of exposure. The Humboldt County questionnaire revealed that a bird feeder in the yard was statistically associated with exposure to ticks, and lifetime number of tick bites was associated with increasing age, time watching wildlife, and time hiking. Three-quarters of respondents were concerned about tick-associated disease, 81.0% reported experiencing tick bites, and 39.0% of those bitten reported a tick-borne disease symptom, including skin lesions (76.4%), muscle aches (49.1%), joint pain (25.5%), or fever (23.6%). Despite high levels of concern, many individuals who had been bitten by a tick were not tested for a tick-borne pathogen, including those with consistent symptoms. We highlight the need for further research and dissemination of information to residents and physicians in Northern California regarding tick-associated disease, so that appropriate medical attention can be rapidly sought and administered.

Sunday, June 16, 2019

Mounting Evidence That Parkinson's Starts in The Gut - Not The Brain

from -

There's Mounting Evidence That Parkinson's Starts in The Gut - Not The Brain

17 MAR 2019

Scientists have found mounting evidence that Parkinson's could start in the gut before spreading to the brain, with one study in 2017 observing lower rates of the disease in patients who had undergone a procedure called a truncal vagotomy.

The operation removes sections of the vagus nerve - which links the digestive tract with the brain - and over the course of a five-year study, patients who had this link completely removed were 40 percent less likely to develop Parkinson's than those who hadn't.

According to the team led by Bojing Liu from the Karolinska Instituet in Sweden, that's a significant difference, and it backs up earlier work linking the development of the brain disease to something happening inside our bellies.

If we can understand more about how this link operates, we might be better able to stop it.

"These results provide preliminary evidence that Parkinson's disease may start in the gut," said Liu.

"Other evidence for this hypothesis is that people with Parkinson's disease often have gastrointestinal problems such as constipation, that can start decades before they develop the disease."

The vagus nerve helps control various unconscious processes like heart rate and digestion, and resecting parts of it in a vagotomy is usually done to remove an ulcer if the stomach is producing a dangerous level of acid.

For this study, the researchers looked at 40 years of data from Swedish national registers, to compare 9,430 people who had a vagotomy against 377,200 people from the general population who hadn't.

The likelihood of people in these two groups to develop Parkinson's was statistically similar at first - until the researchers looked at the type of vagotomy that had been carried out on the smaller group.

In total, 19 people (just 0.78 percent of the sample) developed Parkinson's more than five years after a truncal (complete) vagotomy, compared to 60 people (1.08 percent) who had a selective vagotomy.

Compare that to the 3,932 (1.15 percent) of people who had no surgery and developed Parkinson's after being monitored for at least five years, and it seems clear that the vagus nerve is playing some kind of role here.

So what's going on here? One hypothesis the scientists put forward is that gut proteins start folding in the wrong way, and that genetic 'mistake' gets carried up to the brain somehow, with the mistake being spread from cell to cell.

Parkinson's develops as neurons in the brain get killed off, leading to tremors, stiffness, and difficulty with movement - but scientists aren't sure how it's caused in the first place. The new study gives them a helpful tip about where to look.

The Swedish research isn't alone in its conclusions. In 2016, tests on mice showed links between certain mixes of gut bacteria and a greater likelihood of developing Parkinson's.

What's more, earlier in 2017 a study in the US identified differences between the gut bacteria of those with Parkinson's compared with those who didn't have the condition.

All of this is useful for scientists looking to prevent Parkinson's, because if we know where it starts, we can block off the source.

But we shouldn't get ahead of ourselves - as the researchers behind the new study point out, Parkinson's is complex condition, and they weren't able to include controls for all potential factors, including caffeine intake and smoking.

It's also worth noting that Parkinson's is classed as a syndrome: a collection of different but related symptoms that may have multiple causes.

"Much more research is needed to test this theory and to help us understand the role this may play in the development of Parkinson's," said Lui.

The research was published in Neurology.

A version of this story was first published in April 2017.

Monday, June 3, 2019

Cranberry Compounds Help Prevent Antibiotic Resistance - The People's Pharmacy

Both in test tubes and in insect models, cranberry compounds keep infectious bacteria from developing resistance to common antibiotics.

As bacteria develop resistance to an increasing number of antibiotics, doctors have been searching for a way to counter antibiotic resistance and increase the power of antimicrobial agents. This is a complicated problem, however. As a last resort, researchers have turned to bacteria-munching viruses called bacteriophages. On the other hand, new antibiotics appear to be far in the future. Could cranberry compounds hold a key against resistance?

Read the rest of the story here:

Sunday, June 2, 2019

What is the future outlook for Lyme disease and tick-borne illnesses?

What is the future outlook for Lyme disease and tick-borne illnesses?
Lyme Disease educational opportunities for Health Care Professionals and Patients   |  View Online
Johns Hopkins Lyme Disease Research Center
What does the future hold?
The cumulative prevalence of chronic illness due to Lyme disease in the US is high and growing. One study indicates prevalence may be over a million and as high as 1.9 million in 2020. In the future, geographic expansion of ticks and tick-borne diseases will continue, and climate change will likely further exacerbate the problem.
  • More ticks
  • More regions
  • More tick-borne diseases
  • More people sick with Lyme disease and tick-borne diseases
Solutions our Center provides
  • Improved education and awareness
  • Enhanced rash recognition
  • SLICE Studies biorepository
    • 7000 well-characterized individual blood and tissue samples collected for research
  • SLICE Studies research and collaborations
    • Multidisciplinary research to better understand and validate disease mechanisms and the patient experience
    • Research toward improved diagnostics and treatments
    • Programs with 22 different researchers 
    • 18 different institutions or affiliations
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  Learn More in Our Spring Newsletter  
Third Annual Lyme Disease Topics at Johns Hopkins
Lyme Disease affects over 300,000 new patients every year which are clustered in and around the major metropolitan regions of the Mid-Atlantic and Northeastern United States. Timely diagnosis of acute Lyme Disease depends on the accurate identification of the early erythema migrans skin lesion. Untreated, Lyme Disease can progress to disseminated infection involving the nervous system, heart, and joints. Antibiotic treatment of Lyme Disease is effective in resolving the objective manifestations of infection, however, a subset of patients develop persistent symptoms called Post-Treatment Lyme Disease Syndrome (PTLDS).

Experts from Johns Hopkins have carefully described the patient symptoms, physical findings and laboratory finding in a well document case series of patients with PTLDS.The diagnosis of all manifestations of Lyme Disease and PTLDS in the clinical practice of medicine is challenging and this course seeks to provide education to healthcare practitioners who may see patients with the spectrum of illness associated with Lyme Disease and PTLDS. 

Target Health Care Professional Audience: 
Family Practice, General Practice, Infectious Diseases, Nurse Practitioner, Rheumatology 
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Lyme Disease Awareness Webinar
May 30, 2019 12:00 PM
Find out what you need to know about Lyme disease and tick-borne illness to help keep you and your loved ones safe while enjoying the outdoors.
Aucott, MD;
Soloski, Ph.D.
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Thursday, May 30, 2019

More studies on the effectiveness of various Lyme disease prevention measures

In looking to see if I could find the full text, I came upon this site where a physician rated the study and provided citations.


Effectiveness of personal protective measures to prevent Lyme disease.
Vázquez M, Muehlenbein C, Cartter M, Hayes EB, Ertel S, Shapiro ED
Emerging Infect Dis 2008 Feb; 2(14):210-6

Full Study:  

How can we prevent Lyme disease?
Hayes EB, Piesman J
N Engl J Med 2003 Jun 12; 24(348):2424-30


Emergence of Lyme disease in Hunterdon County, New Jersey, 1993: a case-control study of risk factors and evaluation of reporting patterns.
Orloski KA, Campbell GL, Genese CA, Beckley JW, Schriefer ME, Spitalny KC, Dennis DT
Am J Epidemiol 1998 Feb 15; 4(147):391-7

Full study here:  

Case-control study of risk factors for incident Lyme disease in California.
Ley C, Olshen EM, Reingold AL
Am J Epidemiol 1995 Nov 1; 9 Suppl(142):S39-47

Abstract only:  

Lyme Disease Prevention Results of a Population-Based Case–Control Study

Peridomestic Lyme Disease Prevention

Results of a Population-Based Case–Control Study

Neeta P. Connally, PhD, Amanda J. Durante, PhD, Kimberly M. Yousey-Hindes, MPH, James I. Meek, MPH, Randall S. Nelson, DVM, Robert Heimer, PhD

Background: Purpose:




Peridomestic Lyme disease–prevention initiatives promote personal protection, landscape modification, and chemical control.

A 32-month prospective age- and neighborhood-matched case–control study was con- ducted in Connecticut to evaluate the effects of peridomestic prevention measures on risk of Lyme disease.

The study was conducted in 24 disease-endemic Connecticut communities from 2005 to 2007. Subjects were interviewed by telephone using a questionnaire designed to elicit disease-prevention measures during the month prior to the case onset of erythema migrans. Data were analyzed in 2008 by conditional logistic regression. Potential confound- ers, such as occupational/recreational exposures, were examined.

Between April 2005 and November 2007, interviews were conducted with 364 participants with Lyme disease, and 349 (96%) were matched with a suitable control. Checking for ticks within 36 hours of spending time in the yard at home was protective against Lyme disease (OR􏰎0.55; 95% CI􏰎0.32, 0.94). Bathing within 2 hours after spending time in the yard was also protective (OR􏰎0.42; 95% CI􏰎0.23, 0.78). Fencing of any type or height in the yard, whether it was contiguous or not, was protective (OR􏰎0.54; 95% CI􏰎0.33, 0.90). No other landscape modifications or features were significantly protective against Lyme disease.

The results of this study suggest that practical activities such as checking for ticks and bathing after spending time in the yard may reduce the risk of Lyme disease in regions where peridomestic risk is high. Fencing did appear to protect against infection, but the mechanism of its protection is unclear.

(Am J Prev Med 2009;37(3):201–206) © 2009 American Journal of Preventive Medicine)